CHAPTER TOOLS

Keywords:

Pancreatic cancer;

biliary cancer;

gallbladder cancer;

whipples procedure;

hilar cholangiocarcinoma

Summary

Pancreatic and biliary cancers have a dismal prognosis due to the majority of cancers presenting with innocuous and nonspecific symptoms till they are at an advanced stage. In the small minority of patients deemed potentially resectable, a thorough and comprehensive preoperative assessment of patient fitness and tumor extent is essential in order to avoid the patient undergoing an unnecessary laparotomy. This includes discussion in MDT meeting, anesthetic assessment, and a laparoscopy. Patients deemed unfit or inoperable undergo drainage of their jaundice and referred to the oncologist. Adjuvant chemotherapy postoperatively and primary chemotherapy for inoperable disease have improved survival significantly.